• Nicole Fischer, Amuchou Soraisham, Prakesh S Shah, Anne Synnes, Yacov Rabi, Nalini Singhal, Joseph Y Ting, Dianne Creighton, Deborah Dewey, Marilyn Ballantyne, Abhay Lodha, and Canadian Neonatal Network™ (CNN) and the Canadian Neonatal Follow-up Network (CNFUN) Canadian Neonatal Network (CNN) Site Investigators.
• Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada. Electronic address: nfischer@hollandbloorview.ca.
• Resuscitation. 2019 Feb 1; 135: 57-65.

ObjectiveTo compare mortality and neurodevelopmental outcomes of extremely low gestational age neonates who received delivery room extensive cardiopulmonary resuscitation (DR-CPR) to those who did not require DR-CPR.MethodsPreterm neonates born at <29 weeks' gestational age between January 2010 and September 2011 and assessed at Canadian Neonatal Follow-Up Network centers were studied. Neonates who received DR-CPR were compared to those who did not require DR-CPR using univariate and multivariable analyses. The primary outcome was a composite of mortality or any neurodevelopmental impairment at 18 to 24 months corrected age defined as the presence of any one or more of the following: cerebral palsy; Bayley-III cognitive, language, or motor composite scores <85 on any one of the components; sensorineural/mixed hearing loss or unilateral or bilateral visual impairment. Secondary outcomes were the individual components of the composite outcomes.ResultsOf the 2760 neonates born, 173 were excluded and remaining 2587 eligible neonates were included in our study. Of these 2068 had outcome data (80%) of whom 190 (9.2%) received DR-CPR. DR-CPR was independently associated with mortality or neurodevelopmental impairment (adjusted odds ratio [aOR] 1.76; 95% CI 1.21-2.55) and mortality alone (aOR1.94; 95% CI 1.33-2.83). DR-CPR was also associated with increased odds of motor impairment (aOR 2.03; 95% CI 1.28-3.23).ConclusionIn extremely low gestational age neonates, DR-CPR was associated with higher odds of the composite outcome of mortality or neurodevelopmental impairment, mortality alone, and lower motor scores at 18 to 24 months' corrected age.Copyright © 2019 Elsevier B.V. All rights reserved.

32 keywords...

hide…